By June 15, 2026: Billing and pharmacy teams must update all systems, pharmacy benefit manager interfaces, and prior authorization workflows to require criteria verification for all listed opioid medications (including but not limited to: Xolair, Vonjo, Avinza, Belbuca, Buprenorphine, Butrans, Conzip, Dolophine, Exalgo, Fentanyl, Hydrocodone, Hydromorphone, Hysingla, Kadian, MS Contin, Methadone, Morphine, Nucynta, Opana, OxyContin, Oxycodone, Oxymorphone, Tramadol, Ultram, Xtampza, MorphaBond, Embeda, Codeine, Demerol, Dilaudid, Levorphanol, Meperidine, Pentazocine-Naloxone, Qdolo, Roxicodone, Roxybond, and all combination formulations listed). Effective 07/01/2026, all opioid prescriptions on the affected drug list require documented medical necessity criteria before claim submission. Notify all providers in pain management, palliative care, and primary care specialties of the new requirement. Update encounter templates and prescription verification processes. For Xolair, incorporate new dosing information and H1 antihistamine up-dosing criteria effective 09/01/2026. Claims submitted without proper prior authorization documentation will be denied.